Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY 10032-3725, USA.
Drug Alcohol Depend. 2012 Apr 1;122(1-2):77-85. doi: 10.1016/j.drugalcdep.2011.09.013. Epub 2011 Oct 5.
Exposure to child maltreatment is associated with elevated risk for behavioral disorders in adulthood. One explanation for this life-course association is that child maltreatment increases vulnerability to the effects of subsequent stressors; however, the extent to which maltreatment increases sensitivity to social context has never been examined. We evaluated whether the association between neighborhood physical disorder and binge drinking was modified by child maltreatment exposure.
Data were drawn from the Detroit Neighborhood Health Study, a prospective representative sample of predominately African Americans in the Detroit population. Neighborhood physical disorder was measured via systematic neighborhood assessment. Child maltreatment indicators included self-reported physical, sexual, and emotional abuse. Incident binge drinking was defined as at least one episode of ≥5 drinks (men) or ≥4 drinks (women) in the past 30-day period among those with no binge drinking at baseline (N=1013).
Child maltreatment and neighborhood physical disorder interacted to predict incident binge drinking (B=0.16, p=0.02) and maximum number of past 30-day drinks (B=0.15, p=0.04), such that neighborhood physical disorder predicted problematic alcohol use only among individuals with high exposure to child maltreatment.
The results add to the growing literature that African Americans in the US are exposed to an array of stressors that have pernicious consequences for problematic alcohol use. Our results document the need for increased attention to the potential for at-risk alcohol use among populations with a high degree of stress exposure.
儿童虐待经历与成年后患行为障碍的风险增加有关。这种生命历程关联的一个解释是,儿童虐待会增加对后续应激源影响的易感性;然而,虐待程度增加对社会环境的敏感性的程度从未被检验过。我们评估了邻里物理无序与狂饮之间的关联是否因儿童虐待经历而异。
数据来自底特律社区健康研究,这是底特律人口中以非裔美国人为主的前瞻性代表性样本。邻里物理无序通过系统的邻里评估来衡量。儿童虐待指标包括自我报告的身体、性和情感虐待。新发生的狂饮被定义为在基线时没有狂饮的人中,过去 30 天内至少有一次≥5 杯(男性)或≥4 杯(女性)的饮酒事件(N=1013)。
儿童虐待和邻里物理无序相互作用,预测了新发生的狂饮(B=0.16,p=0.02)和过去 30 天内最大饮酒量(B=0.15,p=0.04),即只有在高暴露于儿童虐待的个体中,邻里物理无序才预测到了问题性饮酒。
这些结果增加了越来越多的文献,表明美国的非裔美国人暴露于一系列对问题性饮酒有严重后果的应激源中。我们的结果记录了需要更多关注高应激暴露人群中潜在的高危酒精使用情况。